NURS 623 Exam 3 Mental Health & GI (Most Questions from FNP Cert Review 3rd Ed), Answered

NURS 623 Exam 3 Mental Health & GI (Most Questions from FNP Cert Review 3rd Ed), Answered-The criteria for diagnosing generalized anxiety disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, 5th edition (text revision) state that excessive worry or apprehension must be present more days than not for at least: a. 1 month b. 3 months c. 6 months d. 12 months - C. The clinician has chosen to prescribe an SSRI instead of a tricyclic antidepressant (TCA) for a patient fitting the diagnostic criteria for depression. Which of the following is not true concerning SSRIs in comparison to tricyclic antidepressants? a. SSRIs are more effective than TCAs. b. SSRIs take less time to work than TCAs. c. SSRIs have a more favorable side-effect profile than TCAs. d. SSRIs are not lethal in overdose. - A A patient is seen with complaints of diarrhea. Which of the following should be included in the patient's differential diagnosis? a. Gastroenteritis b. Inflammatory bowel disease c. Lactase deficiency d. All of the above - D A 25-year-old accountant is seen in the clinic complaining of crampy abdominal pain after meals. She is often constipated and takes laxatives, which are followed by a couple of days of diarrhea. She temporarily feels better after a bowel movement. She states she is embarrassed by flatulence and has abdominal distension. She has had no weight loss or blood in her stool. This problem has gone on for about 6 months. What should the next step be? a. Obtain a complete history. b. Order a barium enema. c. Schedule a Bernstein's test. d. Prescribe a trial of antispasmodics. - A A 28-year-old patient is seen with complaints of diarrhea. Which of the following responses to the history questions would help the primary care physician (PCP) establish the diagnosis of irritable bowel syndrome? a. Feels relief after a bowel movement b. Sometimes is constipated c. Does not defecate in the middle of the night d. All of the above - D Mr. J. K., 38 years old, is 5 feet 8 inches tall and weighs 189 pounds. He reports that he has had intermittent heartburn for several months and takes Tums® with temporary relief. He has been waking during the night with a burning sensation in his chest. Which additional information would lead you to believe that gastroesophageal reflux disease (GERD) is the cause of his pain? a. The pain seems better when he smokes to relieve his nerves. b. Coffee and fried foods don't bother him, c. He wakes at night coughing with a bad taste in his mouth. d. All of the above - C •Which of the following dietary instructions should be given to a patient with GERD? a. Eliminate coffee. b. Drink peppermint tea to relieve stomach distress. c. Recline and rest after meals. d. Limit the amount of antacids. - A • The patient with GERD should be instructed to eliminate which of these activities? a. Swimming b. Weight lifting c. Golfing d. Walking - B Marian, age 52, is obese. She complains of a rapid onset of severe right upper quadrant (RUQ) pain, abdominal cramping, nausea, and vomiting. Your differential diagnosis might be: a. Diverticulitis b. Gastritis c. Cholecystitis d. Appendicitis - C A 46-year-old female patient is seen in the clinic with abdominal pain. Which of the following tests is essential for this patient? a. CBC with differential b. Urine human chorionic gonadotropin c. Barium enema d. Computed tomography of the abdomen - B A patient is seen with complaints of diarrhea. Which of the following should be included in the patient's differential diagnosis? a. Gastroenteritis b. Inflammatory bowel disease c. Lactase deficiency d. All of the above - D Which of the following is part of the treatment plan for the patient with irritable bowel syndrome? a. High fiber diet b. Tylenol with codeine c. Daily laxatives d. All of the above - A A 22-year-old is seen complaining of vague belly pain. This type of pain is seen at what point in appendicitis? a. Very early b. 3 to 4 hours after perforation c. Late in inflammation d. Appendicitis never presents with vague pain. - A Which of the following is most effective in diagnosing appendicitis? a. History and physical b. Sedimentation rate c. Kidney, ureter, and bladder x-ray d. Complete blood count (CBC) with differentials - A The clinician has instructed Sam, a 25-year-old patient with low back strain, to use NSAIDs to manage his symptoms of pain and discomfort. Which of the following statements would be most appropriate when teaching Sam about the use of NSAIDs? a. "You should start with the lowest dose that is effective in managing your pain, because long-term use of NSAIDs can result in gastrointestinal (GI) disorders such as ulcers and hemorrhage." b. "You should start with the lowest dose that is effective in managing your pain to avoid developing tolerance to the medication." c. "You should take the maximum recommended dose of NSAIDs so that you will not need to take narcotics to control your pain." d. "It is important to take NSAIDs on an empty stomach in order to increase absorption." - A Your patient is a 65-year-old man who has been taking a new prescription of rosuvastatin (Crestor) 40 mg daily for 6 weeks. During a follow-up visit, he reports feeling extremely fatigued and having dark-colored urine. He denies any generalized muscle soreness. Which of the following is the most appropriate treatment plan? A. Order a CBC with differential B. Order a liver function profile and CK level C. Recommend an increase in fluid intake and rest D. Order a urine culture and sensitivity test - B